Pure-Tone Audiometry and Masking

First Edition

Maureen Valente

Details: 255 pages, Full Color, Softcover, 5" x 7.5"

ISBN13: 978-1-59756-340-6

© 2009 | Available

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Pure-Tone Audiometry and Masking, one of five texts planned within the Basic Audiometry division of the Core Clinical Concepts in Audiology Series, is a text devoted strictly to these important areas.

Early sections describe integral concepts that provide foundation for the comprehensive audiologic evaluation, such as a basic acoustics overview, equipment, and calibration. This textbook leads the reader through preparation for testing and step-by-step generation of a pure-tone audiogram. Thorough description and many examples are provided relative to major parameters involved in audiogram interpretation: type of hearing loss, magnitude, configuration, and symmetry. The second section of the textbook relates to masking theory and procedures involved in clinical masking, particularly during pure-tone audiometry. Examples are provided here, in addition to sections regarding obtaining valid measures, pearls and pitfalls encountered during testing, audiogram interpretation with common hearing disorders, advanced applications for utilization of pure-tone stimuli in diagnostic Audiology, and more. This textbook serves as a framework for integration of additional audiologic procedures with pure-tone audiometry as its base. Many of the most difficult concepts for a beginning audiology student are addressed: references of the decibel in basic acoustics, calibration of equipment, interpretation of the audiogram, and masking procedures.

Douglas A. Beck, AuD, speaks with Dr. Valente about her book and more in an interview in The Hearing Review. Read the article here.


"4 Stars! This is a current and comprehensive discussion of the important aspects of these procedures that will be useful for undergraduate and graduate students, as well as clinicians. The author has managed to create a unique reference that can serve a number of different purposes from student tutorial to clinical reference for diagnostic or screening audiometry."
Ryan McCreery, M.S. (Boys Town National Research Hospital), Doody's Review Service (2009)

"... A concise review of essential concepts, and protocols intended to help students and audiologists develop fundamental clinical skills in pure-tone testing and masking. It is easy to read and clearly explains potentially confusing concepts all in the context of clinical evaluation."
Colleen M. O'Roarke, Ear & Hearing (2010)

". . . is an excellent resource and reference for the intermediate student, clinicians, and instructors . . . Each chapter of the text reads well and the use of English is correct. The title of the book and chapters are adequately clear . . . Overall, I find Pure-Tone Audiometry and masking to be a well-written and comprehensive review of pure-tone audiometry—the foundation of the audiologic evaluation. It is an excellent resource and reference for the intermediate student, the clinician, and the instructor."
International Journal of Audiology (2011)


  • Foreword by Series Editors James W. Hall, III, Ph.D. and Virginia Ramachandran, Au.D.
  • Preface
  • Acknowledgments
  • About the Author
  • Introduction
    • Rationale for Pure-Tone Audiometry
    • Purposes
    • Scope of Practice Issues
    • References
  • 2. Acoustics Overview
    • Simple Harmonic Motion
    • Frequency
    • Intensity
      db IL (Intensity Level)
      db SPL (Sound Pressure Level)
      dB HL (Hearing Level or Hearing Threshold Level)
      dB SL (Sensation Level)
    • Phase
    • Complex Waveforms
    • References
  • 3. Preparation for Pure-Tone Testing
    • The Hearing Clinic
    • Equipment
      Audiometer Types
      Audiometer Controls
    • Calibration and the ANSI Standards
    • The Daily Listening Check
    • Patient Preparation
    • Infection Control
    • References
  • 4. Threshold: Methods of Ascertaining and Recording
    • Psychophysical Methods
      Method of Adjustment
      Method of Constant Stimuli
      Method of Limits
      Modified Hughson-Westlake Procedure
    • The Audiogram
      Audiometric Symbols
    • Manual Pure-Tone Threshold Audiometric Procedures
      Air Conduction Testing
      The Pure-Tone Average
      Bone Conduction Testing
    • Obtaining a Valid Audiogram
      Clinician Variables
      Patient Variables
      Stimulus Variables
      Environment Variables
    • References
  • 5. Audiogram Interpretation
    • Important Parameters
    • Imparting Pure-Tone Findings
    • References
  • 6. Masking
    • Masking in the Hearing Sciences
    • Clinical Masking
    • Masking Theory
    • Rules of When Masking Should Be Implemented
      Air Conduction (AC) Testing
      Bone Conduction (BC) Testing
    • Types of Noise Used Clinically
    • Plateau
    • Masking Procedure
    • Recording of Results
    • Sensorineural Acuity Level (SAL) Test
    • Challenging Masking Cases
    • References
  • 7. Unconventional Pure-Tone Techniques
    • The Pediatric Patient
      Behavioral Observation Audiometry (BOA)
      Visual Reinforcement Audiometry (VRA)
      Conditioned Play Audiometry (CPA)
      Immittance Audiometry
    • Tuning Fork Tests
    • Nonorganic Hearing Loss
    • Ultrahigh-Frequency Audiometry
    • Conclusions
    • References
  • 8. Identification Audiometry: Hearing Screening
    • Screening for Outer and Middle Ear Disorders
    • Screening of Infants From Birth to Six Months
    • Screening of Toddlers: 7 Months Through 2 Years
    • Screening of Preschool-Aged Children
    • Screening of School-Aged Children
    • Screening of Adults
    • Conclusions
    • References
  • 9. Sample Audiograms: Frequently Seen Hearing Disorders
    • Conductive Hearing Loss
      Otitis Media
      Ossicular Chain Disarticulation
    • Sensorineural Hearing Loss
      Ménière’s Disease
      Noise-Induced Hearing Loss
    • Central Disorders
      Acoustic Neuroma
      Auditory Neuropathy
    • Auditory Processing Disorders (APD)
    • References
  • 10. Pure-Tone Audiometry: Past, Present, and Future
    • Additional Historical Perspective
      Békésy Audiometry
      Tone Decay
      Short Increment Sensitivity Index (SISI)
      Alternate Binaural Loudness Balancing (ABLB)
    • Pearls and Pitfalls: Current Pure-Tone Audiometric Techniques and Masking
      Preparation for Testing
      Pure-Tone Testing Session
      Report Writing
    • Additional Utilizations of Pure-Tone Stimuli
    • Future Trends
    • References
  • Glossary
  • Index

Maureen Valente

Maureen Valente, PhD, earned her Bachelor of Science and Master of Science degrees in Speech and Hearing Science from the University of Illinois in Champaign-Urbana. She spent her Clinical Fellowship Year in the Chicago area, in the office of GE Shambaugh, MD. Subsequent work experiences included private practice and medical settings in the Kansas City and Omaha areas, including employment at Boys Town National Research Hospital in Omaha.

After moving to the St. Louis area, Dr. Valente was employed as a full-time faculty member for eighteen years at Saint Louis University. She graduated with her Doctor of Philosophy degree in Speech and Hearing Sciences from Washington University in St. Louis. Shortly thereafter, she was delighted to accept a position as the Director of Audiology Studies within the Program in Audiology and Communication Sciences (PACS) at Washington University School of Medicine. She carries a joint appointment within PACS and as an Assistant Professor within the university’s Department of Otolaryngology. Areas of interest include development of AuD education, diagnostic audiology, auditory processing disorders, and vestibular evaluation in the pediatric patient.

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